ABSTRACT
Health systems are multidimensional, multifaceted, dynamic, and complex, and implementation of interventions within them occurs across multiple levels. Systems research takes a holistic approach to health service interventions, using a broad perspective to study the different levels at which systems operate and the contexts within which they function.
On the micro level, behaviour change must be a focus when designing and planning interventions, as individuals or teams functionally carry out the implementation of any particular intervention. On the meso (institutional) level, approaches and activities need to account for the continual evolution of health systems and can be facilitated by the implementation of appropriate technological and organizational infrastructures. Macro-level health systems research is crucial to understand the bigger, strategic or policy perspective; improve the uptake of research evidence; and meet the challenge of implementation from the top of the hierarchy. Using a health system research approach to implementation science promotes evidence-informed policy and decision-making while utilizing evidence-informed policies and decisions to improve intervention design. This allows for the participation, ownership, and engagement of stakeholders and key partners across the different levels of the systems for better designed interventions and more successful implementation.
